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BDS4 EXAM STUDY > SDCEP Prevention and Management of Dental Caries in Children > Flashcards

SDCEP Prevention and Management of Dental Caries in Children Flashcards

Paeds SCR

1
Q

What are the aims when providing dental care for children?

A
  • safeguarding wellbeing of child
  • prevent disease in primary/permanent dentition
  • reduce risk of child experiencing pain/infection
    -reducing risk of child developing treatment related anxiety
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2
Q

When should the first child dental assessment be?

A

Before the child is six months old

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3
Q

If you have concerns about dental compliance or attendance of a child, who should you contact?

A
  • parent in first instance
  • child’s health visitor
  • school nurse
  • GMP
  • Childsmile dental health support worker
  • social worker
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4
Q

What should the social history of a child include?

A
  • which adults provide care for the child
  • which days/times are easiest for the parent/carer to bring child
  • name of medical practise they attend
  • name of school/nursery attended
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5
Q

How can you help the younger child with an examination?

A

child sits on parents knee facing them & leans back onto dentists lap

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6
Q

What makes proximal caries detection in primary teeth difficult?

A

broad contact points of primary. dentition

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7
Q

What is the radiograph interval for children with high caries risk?

A

6-12 months

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8
Q

What is the radiograph interval for children with low caries risk?

A

2 years

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9
Q

What approach can you take if a child is very anxious/hesitant to get dental bitewings?

A

systemic desensitisation

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10
Q

What is MIH?

A

hypomineralisation of systemic origin of 1-4 permanent first molars, frequently associated with affected incisors

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11
Q

What does a plaque score of 10/10 indicate?

A

perfectly clean tooth

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12
Q

What does a plaque score of 8/10 indicate?

A

plaque line around cervical margin

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13
Q

What does a plaque score of 6/10 indicate?

A

plaque covering cervical third of crown

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14
Q

What does a plaque score of 4/10 indicate?

A

plaque covering middle third of crown

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15
Q

What factors are known to be associated with development of caries? (make up the caries risk assessment)

A
  • clinical evidence of previous disease
  • dietary habits (sugar)
  • socioeconomic factors
  • use of fluoride
  • plaque control
  • saliva
  • medical history
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16
Q

What SIMD scores are indicative of disadvantage?

A

SIMD 1-3

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17
Q

Which children are more likely to have dental anxiety?

A
  • children with high caries
  • children with parents who have dental anxiety
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18
Q

What can be used to assess a childs dental anxiety level?

A

MCDASf

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19
Q

At what age can MCDAS be used?

A

8 years and older

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20
Q

What is the aim of behavioural management?

A

to promote a positive attitude to dental care & facilitate ongoing prevention and care

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21
Q

List some different behavioural management strategies to manage paediatric patients:

A
  • Enhancing control
  • Tell, show, do
  • Behaviour shaping & positive reinforcement
  • Structured time
  • Distraction
  • Relaxation
  • Systemic desensitisation
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22
Q

What is the motivational interviewing approach?

A

SOARS
- seek permission
- open questions
- affirmations
- reflective listening
- summarising

23
Q

How can you encourage toothbrushing habit formation?

A
  • identify a convenient time and place for the preventive behaviour to occur eg after breakfast
  • identify triggers eg putting on pyjamas
  • review progress at followup appts
24
Q

What evidence backs up toothbrushing with fluoride?

A

SIGN guideline 138

25
Q

When do you use a smear of toothpaste?

A

under 3y/o

26
Q

When do you use a pea-sized amount of toothpaste?

A

3 years & over

27
Q

What toothpaste fluoride concentration should be used for standard prevention?

A

1000-1500ppmF

28
Q

What toothpaste fluoride concentration should be used for enhanced prevention?

A

Under 10 = 1350-1500ppmF

Over 10 = 2800ppmF

29
Q

How does enhanced prevention for children at increased caries risk differ from standard prevention?

A
  • Provide standard toothbrushing prevention at EACH VISIT
  • Hands on brushing instruction (3mins) AT EACH VISIT
  • ## Consider use of high fluoridated toothpaste
30
Q

In which children do we place fissure sealants?

A

ALL children (first permanent molars) as early as possible

31
Q

At what age can you begin to place fluoride varnish?

A

2 years and over

32
Q

What factors influence the optimal outcome of extraction of first permanent molars?

A
  • Calcification of the bifurcation of the 7
  • Presence of all second premolars and third molars
  • Mild buccal segment crowding is present
  • Class I incisor relationship
33
Q

What non-caries removal technique can you use to manage proximal surface caries?

A

SEAL IT IN USING RESIN
- separate the teeth
- isolate the teeth with dam
- etch surface of tooth & rinse well
- apply resin sealant to the tooth surface to be sealed
- check no excess pooling around gingiva
- light cure and floss contact area

34
Q

What is ART?

A

Atraumatic Restorative Technique

35
Q

What caries treatment techniques are discussed in SDCEP paediatric document?

A
  • site-specific prevention
  • no caries removal & seal with fissure sealant/infiltration
  • selective caries removal & restoration
  • stepwise caries removal & restoration
  • complete caries removal and restoration
  • extraction
36
Q

In which scenarios would you perform site-specific prevention?

A
  • Initial proximal caries
  • Initial anterior caries
37
Q

In which scenarios would you perform no caries removal with fissure sealant/infiltration?

A
  • Initial occlusal caries
  • Initial proximal caries
38
Q

In which scenarios would you perform selective caries removal and restoration?

A
  • Moderate occlusal caries
  • Moderate proximal caries
39
Q

In which scenarios would you perform stepwise caries removal and restoration?

A
  • Extensive occlusal caries
  • Extensive proximal caries
40
Q

In which scenarios would you perform complete caries removal & restoration?

A
  • Moderate occlusal caries
  • Moderate proximal caries
  • Advanced anterior caries
41
Q

When is site-specific prevention suitable?

A
  • primary tooth with an initial lesion in occlusal/proximal surface
  • primary anterior tooth with initial lesion
  • primary tooth with arrested caries or when tooth close to exfoliation
  • permanent tooth with initial lesion at proximal surface
  • permanent anterior tooth with an initial lesion
42
Q

What is the aim of site-specific prevention?

A

To stop enamel caries progressing and promote remineralisation of early lesions

43
Q

What is involved in site-specific prevention?

A
  • Show parent/carer & child the carious lesion
  • Demonstrate effective brushing of the lesion
  • Give dietary advice
  • Apply fluoride varnish 4x a year
  • Keep a record of the site and monitor it for plaque biofilm build up/progression
  • If after 3 months active lesions are not arrested/showing signs or inactive lesions have become active consider alternative strategy
44
Q

When deciding not to remove caries & seal them in, what can you use to seal?

A
  • PMC (hall technique)
  • BIS-GMA resin
  • GIC
45
Q

What is the aim of selective caries removal & restoration?

A

Remove sufficient carious tooth tissue to enable an effective marginal seal to be obtained with a bonded adhesive restorative material, inhibiting further progression of residual caries while minimising pulpal damage

46
Q

What is involved in stepwise caries removal & restoration?

A
  • Gain access & remove superficial caries
  • Place a temporary bonded adhesive restoration
  • This inhibits further progression of residual caries whilst allowed reactionary dentine to be laid down
  • Stage 2 carries our 6-12 months later
  • Access cavity and remove caries and final restoration
  • Pulp will be further away from caries now
47
Q

What LA techniques are useful in children?

A
  • Intra-papillary injection (“chasing anaesthesia”)
  • The Wand
48
Q

What different dental services are available for children?

A
  • GDPs
  • PDS or Community Dental Service
  • Hospital Dental Service
49
Q

What children benefit from PDS?

A
  • Pre-cooperative children
  • Children with additional needs
  • Children requiring sedation
50
Q

What is the risk of death from GA for healthy children?

A

<1:100,000

51
Q

What information should be included in a paediatric referral letter for dental care?

A
  • Your details
  • Pt details
  • Pt C/O
  • Clinicians concerns
  • MH + DH + SH
  • Summary of OH
  • Details of request (eg advice only, care plan, tx)
  • Enclosures such as radiographs/study models/photographs
52
Q

What guidelines can you refer to for safeguarding/child protection?

A
  • GDC standards for the dental team
  • Child Protection Guidance for Health Professionals (from Scottish Gov)
  • GIRFEC
53
Q

What are the five key GIRFEC questions that practitioners need to ask?

A
  • What is getting in the way of this child’s wellbeing?
  • Do I have everything I need to help this child or young person?
  • What can I do now to help this child or young person?
  • What can my agency/profession do to help this child or young person?
  • What additional help, if any, may be needed from others?

BDS4 EXAM STUDY (39 decks)

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